| NPI | 1811672959 |
|---|---|
| Former Name | PATRICIA ANN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 14290-66) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 14290-66) |
| Enumeration Date | 2023-06-16 |
| Last Update Date | 2023-11-30 |